As adults grow to middle age and beyond, vision impairment in some form becomes a normal part of the aging process. Nearsightedness, for example, can be easily treated with contact lenses or glasses. However, according to the Centers for Disease Control, more serious age-related eye diseases, such as cataracts and glaucoma, require more intensive treatment and are among the leading causes of vision loss in the U.S.
“According to one study, seniors fear going blind more than anything other than cancer,” said optometrist Dr. Robert Theaker of the Hollister Vision Center. “Both the Academy of Ophthalmology and the American Optometric Association recommend comprehensive annual exams for those over 65 to check for eye diseases and health problems that might affect your eyes.”
According to Theaker, cataracts are the most common eye problem, and untreated cataracts are the single leading cause of blindness worldwide, hitting undeveloped countries the hardest because of a lack of eye doctors and proper care.
Cataracts manifest as haziness in vision resulting from cloudy areas in the eye’s lens. Such changes should be taken seriously, according to Theaker.
“When you get older, there might be multiple issues with your vision,” Theaker said, “If a senior or an elderly person sees noticeable glare outside or halos around lights, that could very well be cataracts, and they should get to an eye doctor immediately.”
According to the Mayo Clinic, cataracts are caused by the proteins and fibers in the lens beginning to break down and decay. Other medical issues may also lead to cataracts, such as previous eye surgery, diabetes or long-term use of steroid medications.
Diagnosis is fairly easy, Theaker said, and it can be done through a simple eye exam.
“It is important that the patient get their eyes dilated,” he said. “That opens up the pupil and lets the doctor really look back deep into the eye for any problems.”
Once diagnosed, treatment is relatively simple, Theaker said. An ophthalmologist can perform surgery to replace the lens.
Before surgery, the patient is given an ultrasound examination to measure the size of the eye to help determine the correct lens type for the implant. There are several different kinds of implants, called “intraocular lenses,” which help to focus light on the back of the eye.
The surgery takes about an hour and is usually an outpatient procedure. Drops are placed on the eye to dilate it, the patient is given local anesthesia and, sometimes, a sedative to help them relax. The old lens is removed, either by dissolving or surgically removing it, and the new lens is put into place.
After the procedure, the patient may be prescribed eye drops and will have to wear an eyepatch for a few days to lessen the strain on the surgery site. There is a chance of blurry vision immediately after the surgery, but it should pass quickly, along with any discomfort, and the eye should be fully healed within eight weeks.
Former San Juan Bautista mayor Cesar Flores underwent cataract surgery on both eyes after having the usual symptoms.
“I went to my eye doctor because I was having cloudy vision and sometimes even double vision, and I didn’t know what was happening,” Flores said. “I couldn’t drive at night because the lights from the cars would just flare up. He checked my eyes and told me I had cataracts.”
Flores consented to the surgery, which he said was quick and painless.
“They cut a little hole in your pupil,” he said. “They told me that the lens is rolled up like a little taco and they stick it through the hole, and it pops open inside. They only did one eye at a time and let it heal before they did the other in case something went wrong, so I would not be blind. But after the surgery, my vision was amazing. I was overwhelmed.”
Glaucoma may not initially seem to have any symptoms, and it is much harder to treat because any damage done to the eye before it’s diagnosed is irreversible.
“With glaucoma, you start to lose your peripheral vision,” Theaker said. “You still have your central vision until the end when you lose everything. And glaucoma is brutal because you don’t know you’re going blind, you don’t initially have any vision loss, and it is painless.”
The loss of peripheral vision is particularly hazardous for drivers who lose the ability to see out of the corners of their eyes.
Yearly glaucoma tests are recommended for diabetics, African Americans over 50, and seniors over 65. Medicare pays 80% for the tests, doctor services, medical supplies, and outpatient care.
During an exam, the doctor will apply a little burst of air to the eye, which tests for any pressure buildup. Fluids in the eye usually drain out through tissue between the cornea and the iris, and when the eye does not drain properly, this buildup creates bulges in the eye.
Eyedrops or medication may be prescribed to lower the pressure in the eye, and laser surgery can improve drainage which also relieves the pressure. But glaucoma is a progressive disease without a cure and may require subsequent treatments to maintain a healthy pressure.
Theaker stresses that yearly exams for seniors are critical for maintaining good vision and are part of Medicare coverage.
“One of the top surgeries of any part in the United States is cataract surgery,” he said. “It’s the highest Medicare payouts that they offer for procedures. With cataract surgery, Medicare pays 80% and if you have a supplemental to your Medicare, that pays the other 20%. So there really is no excuse not to go in and talk to a doctor. Don’t be afraid of having an eye exam. Usually, it will be good news, or the exam will help catch problems. And if it is bad news, there’s a safety net through Medicare to help you get through it.”
BenitoLink thanks our underwriters, California Aging & Disability Resource Connection of San Benito County, for helping expand our senior coverage. The Aging and Disability Resource Connection supports more reporting on senior issues and solutions in San Benito County. All editorial decisions are made by BenitoLink.
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